Amanda Wilde (Host): Using medication for weight loss is surging in popularity. This episode will explore medication management for weight loss and gain insights from bariatric surgeon, Dr. Noman Khan.

Welcome to Flushing Hospital Med Talk, a podcast from Flushing Hospital Medical Center. I'm Amanda Wilde. Dr. Khan, it is so good to have you here to talk about this timely topic.

Dr. Noman Khan: Thank you so much, Amanda. Happy to be here and happy to discuss this medication that many people are interested in and I'm finding to be helpful for so many of our patients.

Host: Well, first of all, you work at Flushing Hospital's Bariatric Weight Loss Center, so that is a dedicated center toward weight loss, but what is a bariatric weight loss center, and what services does it offer?

Dr. Noman Khan: Amanda, not only are we a bariatric center, we're a center of excellence. So, what that indicates is that we have demonstrated a really high level of commitment and expertise, and that our care with bariatric surgery is safe and effective. We subject ourselves to outside organizations, including the American College of Surgeons, American Society for Metabolic and Bariatric Surgery to look at our data and make sure that not only do we have a high volume, but we have excellent outcomes. We have rigorous standards for everything involved in the care. And everyone in our staff is well trained to deal specifically with bariatric surgery. So, we make sure that you're in a place with a lot of confidence and a lot of experience in dealing with bariatric patients, which is a very special population.

Host: And who qualifies as a bariatric patient?

Dr. Noman Khan: That's a pretty wide definition. Usually, it takes some assessment by a bariatric physician to decide whether you're a surgical patient or a medical weight loss patient. However, generally, I can say that we're looking at body mass index as an indicator. And anything above a 30 BMI is usually who we see referred to us to decide what sort of weight loss technique would be best for the patient.

Host: So, there are a variety of surgical interventions for weight loss, but many people are now turning to medications to help them lose weight. Can you explain how this option is intended to work?

Dr. Noman Khan: Yes, definitely. I think that for certain patients, as you said, there's either not an indication for surgery or there's more of an inclination to head towards a medical treatment. These patients are usually patients who are over a certain BMI. And in this example, it would be over a BMI, which stands for body mass index of 27 with a qualifying medical condition, which can be high blood pressure, diabetes, high cholesterol or sleep apnea or above a BMI of 30 without another qualifying condition. So, that's generally who we look for to categorize into the medical weight loss.

Host: Is there a screening process then before starting medications for weight loss?

Dr. Noman Khan: Yes, we want to make sure that, number one, the patient is interested and wants to undergo weight loss with medical treatment because of course it's a commitment. Not only do you need to see your weight loss physician regularly, but you need to be willing to meet with a nutritionist. You also need to be willing to meet with your primary care physician more often as well as various blood tests to make sure that our treatment is going well and that all your parameters look good

Host: So, there are patient responsibilities during the course of this treatment.

Dr. Noman Khan: Yes, definitely. I think that one of our first questions when a patient enters into treatment with us is do you understand the commitment that it takes to undergo weight loss? Meaning that we need you here a certain amount of times with a certain frequency, we need you to check in with the nutritionist. We'd like to advise on an exercise plan for patients who are able to exercise. So, there's certainly more than just the medication involved in the weight loss process.

Host: And then, on the other side, are there any side effects or cautions patients should be aware of before choosing this option?

Dr. Noman Khan: Yes. And I'm going to be brief on the ones that are most common. However, there is definitely a larger insert and a larger discussion to be had with the patients who start weight loss medication. But the most common that we see reported with the most common weight loss medications that I'm going to speak about, which are the two injectable medications, ZepBound is most commonly prescribed as well as Wegovy, is we see cramping, we see some nausea, sometimes even vomiting, constipation, and diarrhea. However, I will say that the vast majority of the patients do not have severe side effects. They sometimes have minor side effects, especially with the cramping and the nausea for the day of injection and the day after. It's a once weekly injection.

Host: So percentage-wise, would you say fewer people experience side effects than do?

Dr. Noman Khan: Yes, certainly. I would say that less than 10% experience significant side effects and much lower than that experience significant side effects that causes them to discontinue the medication.

Host: And what should someone who chooses this option expect in terms of weight loss?

Dr. Noman Khan: That varies widely, and the reason it does is because it depends on not only, of course, taking the medication and adhering to it and being able to handle it, but someone who starts at a higher BMI and a different metabolic condition definitely will lose less or more than someone starts at a lower BMI with different conditions.

But in general, we expect to see about 15-20% of the total body weight and a significant amount of the excess body weight lost. But again, it also depends on exercise, nutrition, and other qualifying conditions.

Host: Is there followup from the center after weight loss is complete?

Dr. Noman Khan: So once you become a patient of mine, you essentially usually become a patient of mine for life. Certainly for surgery, we expect to see you pretty frequently in post-surgery and then, after surgery, usually six months to yearly for life. As far as medication goes, we follow the patient after the weight loss goals have been achieved. And then after that, we continue to follow them for a period of time until the patient and I are both confident that we feel like the weight loss counseling has succeeded. And then, at that point, it's an open door to return at any point, if there's any regain of weight or any concern about where their weight is headed.

Host: And overall, you mentioned your center of excellence and so that connotes success. How would you rate the success of Flushing Hospital's Bariatric Weight Loss Center? How successful is it?

Dr. Noman Khan: It is extremely successful, especially when you look at national averages. We are in the top percentile for many, many data points in how successful we are. And one of the big things that we do is that we make sure that weight loss with us is looked at from multiple angles. Weight loss and obesity and associated conditions are certainly not a one-sided thing to deal with. They are multifactorial. They require many different professions to all come together and make sure that we give our patients the best shot at not only losing weight. But just as importantly, keeping the weight off and we've become exceedingly good at that.

Host: For anyone who's interested in getting in touch or learning more about weight loss therapies offered at Flushing Hospital's Bariatric Weight Loss Center, how should they contact you?

Dr. Noman Khan: They can come to our website at flushinghospital.org, or they can call our Bariatric Center of Excellence at 718-408-6977.

6977. Well, thank you so much, Dr. Khan. Continued success in your work at Flushing Hospital's Bariatric Weight Loss Center.

Thank you, Amanda. Appreciate it.

Host: That was bariatric surgeon, Dr. Noman Khan. The phone number for Flushing Hospital's Bariatric Weight Loss Center is 718-408-6977. For more information about the services Flushing Hospital offers, visit our website at flushinghospital.org.

All content of this podcast is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Please consult a medical professional before adapting any of the suggestions discussed in this podcast. This is Flushing Hospital's Med Talk, a podcast from Flushing Hospital Medical Center.